| Summary: | Introduction: Today, significant resources are spent on accreditation in over 70 countries. Yet the documentation of the effects of accreditation on processes and outcomes of healthcare is still scarce. Thus, robust empirical studies are needed to justify the expense of time and money. Objectives: To examine the delivery of recommended patient care before and after the first-time hospital accreditation in the Faroe Islands. Hypothesis: Patients will receive more recommended patient care when treated in a hospital that has undergone accreditation. Methods: We conducted a before and after study on the Faroe Islands in connection with introducing accreditation in 2017. We compared the fulfillment of process performance measures through audit of patient records. The recommended patient care was evaluated against 67 process performance measures reflecting the national clinical guidelines. Process performance measures were calculated, as an opportunity-based composite score (percentage adherence to process performance measures) and an all-or-none score (100% adherence to process performance measures). All three hospitals participated. A random sample of patients ≥18 years, with one of seven clinical conditions (stroke/transient ischemic attack (TIA); bleeding ulcer; diabetes; chronic obstructive pulmonary disease (COPD); child birth; congestive heart failure; hip fracture) were included if they were in- or outpatients from 2012 to 2013 (before accreditation) or 2017 to 2018 (after accreditation). 345 We calculated the relative risk, risk difference and percentage difference for receiving recommended patient care using Poisson and linear regression, respectively. In all cases, we used mixed effects analyses with a random intercept at patient and hospital level. Results: A total of 475 inpatients and 392 outpatients from the three Faroese hospitals participated. The total opportunity-based composite score, including all clinical conditions, was slightly higher after hospital accreditation (adjusted difference percentage ...
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